To older LGBTQ+ adults, today can feel like the AIDS crisis all over again.
Friends disappearing in ambulances. Calling hospitals, unable to find them. Weeks spent at hospital bedsides. Back-to-back deaths. So many funerals.
But now, 45 years since the first AIDS diagnosis kicked off a crisis that defined life for a generation of LGBTQ+ people, it’s not young people dying at alarming rates. It’s old people dying at expected rates.
Jason Cuneo, who leads senior programs at the San Diego LGBT Community Center, watched six clients die in a year. It reminded him of when he began HIV advocacy in 1992.
“The third one passed away, I was a mess,” he said. “It triggered all the memories of doing that day after day after day. And I thought, ‘are we having to go through this again just because everyone’s aging?’
“It was really depressing and very hard. And I see that in the community where there’s just kind of a weight in the sadness of that starting to happen.”
San Diego County’s LGBTQ+ senior population is growing alongside the general senior population, as nationwide, the Williams Institute at UCLA estimates there are 2.4 million LGBTQ+ adults over age 50.
The young or middle adulthood of those LGBTQ+ seniors was defined by an AIDS crisis that radicalized them as they watched peers die amid government inaction. Some did survive, with over half of the 14,000 people living with HIV in San Diego County now over 50.
But the experience of losing so many people was traumatizing. Reliving it again due to heart disease, cancer and strokes reignites those memories. Many are withdrawing to protect themselves. Others are amping up their organizing, relying on skills refined at Act Up and other advocacy groups.
Inside North Park Seniors organizing
At North Park Seniors, where dozens of low-income LGBTQ+ seniors live, the building hosts bingo events like any senior housing center, but the residents also open their doors to substance abuse recovery groups and weekly events for Pozabilities, the social group for HIV+ seniors.
“A building full of mostly straight people could not get this stuff organized,” resident Mike Sloothaak said.
To some of the residents, it was the organizing experience of the AIDS epidemic — whether they had the disease or just supported those with it — that enabled them to navigate resources, build community events and help others as seniors.
“We have certain experiences that are unique to our generation,” Sloothaak said. “We started to take care of each other long before we became seniors, so we know how to do that. So when we get older … it’s not a shock to us that we have to take care of each other.”
In June, the residents held a rummage sale, raising $700 to stock supplies in the community room.
The Center, as San Diego’s LGBT center is known, hosts a monthly Senior Lunch & Learn event at the building, but the residents held the fundraiser to pay for other dates on their social calendar, namely monthly birthday parties and an annual Halloween event.
“If anybody gets bored here, we think of a reason for parties,” resident Shelly Lorenze said.
Community HousingWorks developed the North Park Seniors building in 2018 as the city’s first LGBTQ-affirming housing community. The majority of units are reserved for independent-living, low-income seniors.
The building is not restricted to LGBTQ+ people, but many of its residents are part of the community because The Center ran the building’s resident waiting list. The Center also provides tailored programming and a part-time case manager.
Eight years since it opened, the residents themselves transformed the building into a thriving community that supports outside LGBTQ+ community groups and aging residents.
“Before I moved here, really, all I had to look forward to was doctors,” resident Terry Vaughn said. “Now I’m exposed to theater, the ball game, the symphony.”
The residents also rally around neighbors who start to deteriorate. Recently, that meant organizing dog walking shifts for a resident with mobility issues. A few years ago, they helped the building’s most prominent resident, lesbian activist Jeri Dilno, who lived there until her death.
Dilno, who died at age 86 in 2024, had many social connections through her leadership at Pride, The Center and San Diego Democrats for Equality. She still relied on her neighbors for care.
“Because of this place, she felt so loved,” Lorenze said.
Being accepted to live at North Park Seniors felt like winning a lottery to Lorenze. Sloothaak pointed out that, like other residents, she had in fact won a lottery to live there.
A lonely housing experience
Not every LGBTQ+ senior won that lottery. Others must secure housing elsewhere.
For David Tworkowsky, who lives alone, cheap rent in the Midway district also made him a target of harassment and an intimidation campaign he couldn’t afford to escape.
“Because I’m the queer in that community of 900 people,… I live there in fear,” Tworkowsky said. “I get the lowest rent in San Diego, and I paid a big price.”
In June, Tworkowsky attended a Lunch & Learn event at the LGBT Center, where he knew he wouldn’t be discriminated against for being gay.
The Center has more than doubled its senior offerings in recent years, and now offers free food and activity nearly every weekday. It’s a safe space for LGBTQ+ seniors, who sometimes go back into the closet to avoid harassment and discrimination from the service providers they depend on.
“There’s a level of anxiety that I haven’t seen in a while, and stress that folks are coming in with, so (it’s good) to have a place where they can find commonality, where they don’t have to go back in the closet,” Cuneo, who plans the senior services, said. “They don’t have to worry about that here. So it’s just come as you are and have community.”
Cuneo believes the events build important social connections, combatting the elevated rates of depression, anxiety, suicidal ideation and psychological distress linked to a lifetime of exposure to stigma and discrimination that LGBTQ+ seniors have experienced.
Combatting loneliness
Thomas Vegh, who founded Diversionary Theatre 40 years ago, began attending Center events this year after realizing he did not have support as his health worsened.
“It’s a lonely type of quality that I have,” he said. “Socialization is a big challenge for me. I have one good friend and I have a couple of acquaintances, and that’s it. I don’t have family.”
Vegh points to losing friends, mentors and lovers during the AIDS crisis as the reason for his loneliness. After watching people die and developing survivor’s guilt in the aftermath, Vegh did not pursue new relationships.
Only in the past year did he seek out new places to socialize: St. Paul’s Cathedral, The Center, Coronado Playhouse, where he was cast in a show.
In a survey of 400 local LGBTQ+ seniors The Center conducted prior to North Park Seniors’ opening, respondents listed their top concern as social isolation and a lack of family, social and community support. The next greatest concerns were lack of culturally-competent medical care, lack of financial resources and lack of safe housing.
National surveys show the same results. LGBTQ+ seniors are twice as likely to be single and live alone as their straight counterparts, according to a 2021 poll by Sage USA and the National Resource Center on LGBT Aging.
Caregiving challenges without blood ties
Senior care in this country is often based on the presumption that younger family members, typically adult children, manage care for aging relatives. For low-income seniors, it’s often family members themselves doing unpaid care, not just managing it.
But built-in familial support isn’t automatic for LGBTQ+ seniors, who are four times less likely to have children than the rest of the elderly population, Sage USA found.
“My daughter has four legs and a tail,” said Nancy Peterson, who attends Center events and lives at North Park Seniors. She planned how she wants to be buried, but not what to do if she needs additional care before then. “There’s no family here … That’s a big thing to think about as well.”
Friends step into the care gap. But that can make it harder to conduct a welfare check or make a hospital visit without blood ties or legal documentation.
Something as simple as family leave from a job can be turned down without those formal ties.
“Gay families, lesbian families, they’re not by blood,” Sloothaak said. “That heterosexual nuclear family is presumed to be the proper thing, and if you don’t have that, you are at a disadvantage. You have to go get documents, you have to go to a lawyer.”
John Keasler recalled one North Park Seniors neighbor who was admitted to the hospital without giving power of attorney to someone local.
“When he went to the hospital, he never came back,” Keasler recalled. Even a roommate could not find out which hospital he was in. To Keasler, it felt like the AIDS crisis all over again.
Tony Alexander and his best friend took care of each other as they aged, doing everything together from daily dog walks, yoga and dinners until the friend died.
“When he died, it was like a piece of me died, because it was a big part of my life that’s gone, it’s erased,” Alexander said. “Within one day it all changed, and he’s gone. I still am not used to it. I still can’t believe that he’s not here anymore.”
It also left Alexander without someone to help him navigate his own frail health.
”Often the folks doing the caregiving are not the best person to be doing it, because they’re struggling themselves,” Cuneo said.
While new medications have made HIV manageable, many suffer from comorbid illnesses and even long-term side effects from experimental medicines that impact pancreas and liver function.
“A lot of my illnesses are related to HIV,” said Alexander, pointing to discoloration on his arms while waiting for a free memory assessment at The Center.
Just as they were the first generation to experience HIV, they are now the first generation to experience aging with it. That means discovering new unknowns with the virus.
Financial concerns
In early years, an HIV diagnosis guaranteed a prolonged and degrading death. Many patients embraced a live-like-you’re-dying ethos, the “No Day But Today” attitude of “Rent” in real life.
For those who died, embracing vive ut vivas – Latin for “live so that you may live” – helped them find joy and purpose. But for people who avoided a death sentence they thought was certain, it resulted in a lack of preparation for retirement.
Even guaranteed government financial benefits, like Social Security, are impacted by the epidemic because many young patients left careers when they became disabled, resulting in smaller payments.
With thousands of HIV-positive people in San Diego over the age of 50, a population exists that community services aren’t equipped to handle. Aging services are already strained by a general boom in seniors. The specific needs of HIV-positive seniors compound the issue.
Mike Haynie-Valdivia’s first husband died of HIV/AIDs in 1994, but he is a long-term survivor.
“I had to watch him die, take care of him,” Haynie-Valdivia said.
Last year, his own health failed as memory loss left him disabled. As his condition worsened and he could no longer work, good friends ensured he did not become homeless. Despite their separation, his ex-husband stepped in for many daily needs.
“My Jim would do anything for me,” Haynie-Valdivia said. “He would come help me … You need that.”
His informal support network kept him alive. Now, his memory is improving.
